Life Line Medical Group INC

NPI #1174122337 in Miami, Florida

Provider Information

NPI Number
1174122337
Entity Type
Organization
Organization Name
Life Line Medical Group INC
Primary Specialty
General Practice
Enumeration Date
Oct 20, 2020
Last Updated
Oct 20, 2020

Practice Location

Address
12595 SW 137TH AVE STE 206
City
Miami
State
Florida
ZIP Code
33186-4221
Phone
(786) 474-0541

Authorized Official

Name
EULOGIO EMILIANO BENITEZ
Title
PRESIDENT
Phone
(786) 474-0541

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care
General Practice

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